Oral antiplatelet drugs in patients with chronic kidney disease (CKD): a review

被引:6
作者
Ibrahim, Homam [1 ]
Rao, Sunil V. [2 ,3 ]
机构
[1] NYU, Langone Med Ctr, 530 1st Ave Skirball 9V, New York, NY 10016 USA
[2] Duke Univ, Med Ctr, Durham, NC USA
[3] Duke Clin Res Inst, Durham, NC USA
关键词
Antiplatelet drugs; Chronic kidney disease; Platelet dysfunction in CKD; PLATELET THROMBIN RECEPTORS; GLOMERULAR-FILTRATION-RATE; ACUTE CORONARY SYNDROMES; CARDIOVASCULAR-DISEASE; HEMODIALYSIS-PATIENTS; IMMATURE PLATELETS; RENAL IMPAIRMENT; DOSE CLOPIDOGREL; OUTCOMES; THERAPY;
D O I
10.1007/s11239-017-1483-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Oral Antiplatelet Drugs (OAD) have a proven track record in the risk reduction of major cardiovascular events in patients with cardiovascular disease and normal kidney function. However, major gaps exist in our understanding of their effects on thrombosis and bleeding in chronic kidney disease (CKD). Clinical practice guidelines are ambiguous about use of such drugs in CKD patients, because patients with moderate to severe CKD were systematically excluded from clinical trials evaluating the efficacy and safety of OAD. Paradoxically, CKD patients are at high risk of thrombosis and major bleeding events. Thus, choosing the right combination of OAD for cardiovascular protection in these patients is challenging. Patients with CKD exhibit high rates of OAD hyporesponsiveness. It is, therefore, imperative to explore the mechanisms responsible for poor response to OAD in CKD patients in order to use these drugs more safely and effectively. This review explores suggested mechanisms of platelet dysfucntion in CKD patients and the available evidence on the efficacy and safety of oral antiplatelet drugs in patients with renal dysfunction.
引用
收藏
页码:519 / 527
页数:9
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